Hypoglycemia Reduction Strategies in the ICU
| Autor: | Thaer Idrees, Oluwakemi T. Soetan, Dharmesh B. Bavda, Susan S. Braithwaite, Faisal Qureshi |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism medicine.medical_treatment Renal function 030209 endocrinology & metabolism Hypoglycemia Kidney Insulin dose 03 medical and health sciences 0302 clinical medicine Bolus (medicine) Insulin Infusion Systems Diabetes mellitus Internal Medicine Medicine Humans Insulin Intensive care medicine business.industry Critically ill 030208 emergency & critical care medicine medicine.disease Intensive Care Units business Risk Reduction Behavior Kidney disease |
| Zdroj: | Current diabetes reports. 17(12) |
| ISSN: | 1539-0829 |
| Popis: | We reviewed the strategies associated with hypoglycemia risk reduction among critically ill non-pregnant adult patients. Hypoglycemia in the ICU has been associated with increased mortality in a number of studies. Insulin dosing and glucose monitoring rules, response to impending hypoglycemia, use of computerization, and attention to modifiable factors extrinsic to insulin algorithms may affect the risk for hypoglycemia. Recurring use of intravenous (IV) bolus doses of insulin in insulin-resistant cases may reduce reliance upon higher IV infusion rates. In order to reduce the risk for hypoglycemia in the ICU, caregivers should define responses to interruption of continuous carbohydrate exposure, incorporate transitioning strategies upon initiation and interruption of IV insulin, define modifications of antihyperglycemic therapy in the presence of worsening renal function or chronic kidney disease, and anticipate the effects traceable to other medications and substances. Institutional and system-wide quality improvement efforts should assign priority to hypoglycemia prevention. |
| Databáze: | OpenAIRE |
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